New trends in the treatment of breast cancer at the Cancer Institute of Milan.

Preliminary results from three trials on breast cancer treatment carried on at the National Cancer Institute of Milan are presented. In the first trial, radical mastectomy (105 patients) was compared to a more conservative procedure consisting of breast resection, axillary dissection, and radiation therapy (125 patients). Axillary metastases were found in 22% and 25% of the two groups, respectively. After 30 months, two local recurrences have occurred, one in each group. Four patients in the radical mastectomy group have developed distant metastases. In the second trial, carried out on patients with nodal involvement, radical mastectomy (179 patients) was compared to radical mastectomy followed by a prolonged combination chemotherapy using cyclophosphamide-methotrexate-fluorouracil (207 patients). After 27 months, recurrences have occurred in 24% of the patients treated only with radical mastectomy compared to 5.3% in those treated with radical mastectomy plus chemotherapy. In the third trial, 67 patients with inoperable breast cancer were treated with chemotherapy plus radiation therapy. Recurrences occurred at a lower rate than observed in a previous series of patients treated with radiotherapy alone.